Kornimate/medical-research-clean huggingface dataset:
ultrasound-guided lung recruitment maneuvers for postoperative pediatric atelectasis

Conditions: Atelectasis; Postoperative Complications; Recruitment; Pediatric; Abdominal Surgery

Summary: in anesthetized children, the incidence of lung collapse with episodes of hypoxemia is high. diaphragmatic dysfunction induced by general anesthesia is one of the most important factors in the genesis of regional losses of lung aeration. the mass of the abdominal organs pushes the diaphragm cranially compressing the lungs in the most dependent areas. such regional lung collapse may range from a slight loss of aeration to complete atelectasis.

a wide variety of recruitment maneuvers has been described. the most relevant are represented by sustained inflation maneuvers, high pressure-controlled ventilation, incremental peep, and intermittent sighs. however, the best recruitment maneuver technique is currently unknown and may vary according to the specific circumstances. the most commonly used recruitment maneuver is the sustained inflation technique, in which a continuous pressure of 40 cm h2o is applied to the airways for up to 60 seconds. sustained inflation has been shown to be effective in reducing lung atelectasis, improving oxygenation and respiratory mechanics, and preventing endotracheal suctioning-induced alveolar derecruitment. however, the efficacy of sustained inflation has been questioned and other studies showed that this intervention may be ineffective, short-lived, or associated with circulatory impairment, an increased risk of baro/volutrauma, a reduced net alveolar fluid clearance, or even worsened oxygenation. lung ultrasound has been gaining consensus as a noninvasive, radiation-free tool for diagnosing various pulmonary diseases in adult and pediatric patients. evidence supporting lung ultrasound use is expanding beyond emergency and critical care settings to perioperative care. it has been reported that lung ultrasound (lus) at a patient's bedside immediately following surgery can be useful for diagnosing respiratory complications. lus has been proven to be a valuable bedside diagnostic tool for pneumothorax, with high sensitivity and specificity (78.6% and 98.4%, respectively), and a higher rate of detecting abnormalities such as lung alveolar consolidation and pleural effusion than bedside chest x-ray or physical examination. lus has also been used to diagnose anesthesia-induced atelectasis in pediatric patients.

Eligibility criteria:
inclusion criteria: * patients scheduled for laparoscopic abdominal surgery * american society of anaesthesiologist class i \& ii exclusion criteria: * pre-existing cardiac disease. * morbidly obese patients according to age. * patients with previous thoracic or cardiac surgery. * upper or lower airway infection within 2 weeks before the surgery. * lung ultrasound abnormalities including patches, pneumothorax, and pleural effusion. * abnormal preoperative chest x-ray findings including atelectasis, pneumothorax, pleural effusion or pneumonia. * preoperative oxygen saturation measured by pulse oximetry (spo2) of 96% or less on room air.
erector spinae plane block with dexmedetomidine and bupivacain versus dexamethasone and bupivacain for postoperative analgesia in patients undergoing abdominal surgeries

Conditions: Analgesia, Postoperative

Summary: to compare the analgesic effect of dexmedetomidine combined with bupivacaine versus dexamethasone combined with bupivacaine for ultrasound-guided espb for postoperative pain control in patients scheduled for abdominal surgeries


Eligibility criteria:
inclusion criteria: age :18 years old and older. patients undergoing open abdominal surgery. exclusion criteria: 1. patient refusal 2. known sensitivity or contraindication to any of study drugs 3. contraindications for local anesthesia 4. patients with local infection at site of puncture 5. uncooperative patients 6. history of psychological disorders or chronic pain and significant liver or renal disease.
cardiovascular phenotype study in patients with obstructive sleep apnea syndrome

Conditions: Obstructive Sleep Apnea Syndrome; Hypertension

Summary: patients with obstructive sleep apnea syndrome have permanent variations of their hemodynamic parameters during the night : heart rate, arterial blood pressure, cardiac output. this is due to the repetition of respiratory events (obstructive apnea and hypopnea) leading to frequent micro-arousals. these disorders have several consequences : hypertension, no-dependent vasodilatation impairment, baroreceptor reflex impairment, insulin resistance and other cardiovascular impairments.

objective of the study is to characterize the cardiovascular phenotype of patients with obstructive sleep apnea syndrome, relative to the presence of hypertension or not. hypertension should not have been previously treated. 2 groups of apneic patients (sas+hta+ and sas+hta-) will be compared together, referred to group of non apneic but hypertensive patients (sas-hta+) and non apneic / non hypertensive patients (sas-hta-). apneic and hypertensive patients may have a sympathetic nervous system activation and a much more important vascular and baroreceptor reflex impairment, than non apneic but hypertensive patients. during the study, a second visit as control will be done for apneic patients only, 3 to 6 months after sas treatment setting.

Eligibility criteria:
inclusion criteria: * patients with or without obstructive sleep apnea syndrome (ahi \> 15) * patients with or without hypertension exclusion criteria: * known or expected secondary hypertension * pathologies with consequences on arterial blood pressure regulation: parkinson's disease, patients with renal or cardiac graft, severe heart failure * drugs with consequences on arterial blood pressure regulation : vasoconstrictors, vasodilatators, béta-agonists, antagonists, nitrites, theophylline, dipyridamol, sildenafil, immunosuppressors, imao, neuroleptics, tricyclic antidepressants, corticoids or long-term oral (\>10 days) non steroidal anti-inflammatory drugs, oestroprogestative treatments * atrial fibrillation, frequent extrasystoles (\> or = to 10/minute) * bedridden patients * night shift workers * surgical or carotid stenting history * subjects unwilling or unable to provide written, signed and dated informed consent * patient previously treated for obstructive sleep apnea syndrome (positive airway pressure, forward mandible prosthesis, maxillofacial surgery

Keywords: obstructive sleep apnea syndrome hypertension cardiovascular phenotype
palliative dose escalated radiation for painful non-spine bone metastases and painful non-bone metas

Conditions: Neoplasm Metastases; Metastases, Neoplasm

Summary: the investigators hypothesize that with dose escalation to 40-50 gy in ten fractions, the complete pain response rate at one month can be increased to 40-50% in painful non-spinal bone metastases. additionally, the investigators hypothesize that utilizing a fractionation scheme with an escalated biologically equivalent dose (bed) will result in a higher proportion of participants responding to treatment, and will also lead to more durable responses. furthermore, the investigators hypothesize that with dose escalation to 40-50 gy in ten fractions, the complete pain response rate at one month can be increased to 35-45% in painful non-bone metastases

the purpose of this study is to prospectively evaluate dose escalation and pain response in patients with painful non-spinal bone metastases and painful non-bone metastases treated with radiation therapy. primary objective: to evaluate improvement of complete pain response rate in painful non-spine bone metastases and painful non-bone metastases with dose escalated radiation using a ten fraction radiation regimen secondary objectives: to evaluate best pain response to evaluate mean pain scores to evaluate the duration of pain response to evaluate the changes in quality-of-life following radiation to evaluate the rates of retreatment with radiation secondary to disease or symptom progression to evaluate treatment related toxicity

Eligibility criteria:
inclusion criteria: * have provided signed informed consent for the trial * aged ≥18 years at the time of informed consent * histologic proof of malignancy * radiologic or histologic evidence of bone metastases or non-bone metastases * eastern cooperative oncology group (ecog) performance status of ≥3 * pain score ≥ 3 * life expectancy of six months or more * willing and able to comply with all aspects of the protocol * a female participant is eligible to participate if she is not pregnant and not breastfeeding * woman of childbearing potential who agrees to follow contraceptive guidance during the treatment period and for at least 120 days after the last dose of study treatment. * a male participant must agree to use contraception during the treatment period and for at least 120 days after the last dose of study treatment. exclusion criteria: * metastasis from a highly radiosensitive tumor (eg, lymphoma, myeloma, germ cell tumor) * spinal metastasis * active compression of spinal cord/cauda equina * previous rt or sbrt to the same site * \> 3 sites requiring radiation treatment

Keywords: metastase bone neoplasms dose fractionation, radiation
registry platform myelofibrosis and anemia

Conditions: Primary Myelofibrosis; Secondary Myelofibrosis; Post-polycythemia Vera Myelofibrosis; Post-essential Thrombocythemia Myelofibrosis; Anemia; Myelofibrosis; Anemia; Myelofibrosis

Summary: the purpose of the project is to set up a national, prospective, longitudinal, multicenter cohort study, a tumor registry platform, to document uniform data on characteristics, molecular diagnostics, treatment and course of disease and to collect patient-reported outcomes for patients with primary and secondary myelofibrosis and anemia in germany.

rhodolite is a national, prospective, open-label, longitudinal, non-interventional multicenter cohort study (tumour registry platform) to describe treatment in routine clinical practice of myelofibrosis patients in routine care in germany. the registry will follow patients for up to three years with the aim to identify common therapeutic sequences and changes in the treatment of the disease. at inclusion, data in patient characteristics, comorbidities, tumor characteristics and previous treatments are collected. during the course of observation data on all systemic treatments and outcome are documented. health-related quality of life (hrqol) will be evaluated for up to three years. the rhodolite clinical registry is a joint project with the german study group for myeloproliferative neoplasms (gsg-mpn) and its gsg-mpn bioregistry (nct03125707). details on treatment and outcome will be collected in rhodolite clinical registry for up to three years, while long-term follow-up for a minimum of additional five years will be performed in the gsg-mpn bioregistry.

Eligibility criteria:
inclusion criteria: * confirmed diagnosis of primary or secondary (post-polycythemia vera or post-essential thrombocythemia) myelofibrosis (mf) (note: diagnosis according to who-2017, icc-2022 or who-2022 or iwg-mrt criteria, respectively). * diagnosis of anemia at the time of enrollment as per individual, clinical assessment by the local physician. * start of first or subsequent systemic treatment for mf. * informed consent and registration for the gsg-mpn bioregistry. * willingness and capability to participate in pro assessment. * signed and dated informed consent form for rhodolite at the latest six weeks after start of the respective systemic mf treatment. exclusion criteria: * no systemic therapy for diagnosed primary or secondary mf. * planned allogenic stem cell transplantation (allo-sct) or active participation in an interventional clinical trial.
sex hormone and vascular function in women with ckd

Conditions: Chronic Kidney Diseases

Summary: the risk of cardiovascular disease (cvd) is significantly elevated in patients with chronic kidney disease (ckd). notably, women with ckd commonly experience menstrual disturbances induced by ckd, which may contribute to impaired vascular function and elevated cvd risk. however, most of the literature in the field of nephrology focuses on male patients, and studies on women's vascular health are limited. moreover, endogenous sex hormones, particularly estradiol, are well-documented to be cardioprotective in women without ckd; however, the role of sex hormones on vascular function in women with ckd remains unclear. the goals of the proposed project are: 1) to evaluate vasuclar function in pre- and post-menopausal women with ckd vs. age-matched healthy women; 2) to evaluate sex hormone concentrations and determine whether they associate with vascular function in the proposed cohort; and 3) to gain mechanistic insight on the association between sex hormones and vascular dysfunction in the proposed cohort.


Eligibility criteria:
inclusion criteria: 1. pre- (18-44 y) and post-menopausal (55-75 y) women 2. individuals with ckd including stage 3-4 (egfr 15-59 ml/min/1.73m2) determined by the chronic kidney disease epidemiology collaboration (ckd-epi) equation and/or urinary albumin-creatinine ratio (uacr) ≥ 30. 3. controls must be healthy (free from hypertension, kidney disease, cardiovascular disease, diabetes, and other chronic disease as assessed by self-report, medical history, and screening labs). premenopausal healthy women must have a regular menstrual cycle (25-35 d). exclusion criteria: 1. perimenopausal (45-54 y) women 2. pregnancy, lactation, or less than one year post-partum 3. use of hormonal birth control methods, hormone replacement therapy, or a levonorgestrel intrauterine device (iud) insertion for a duration less than 6 months 4. advanced ckd requiring dialysis 5. history of kidney transplant 6. use of immunosuppressant medications (unless taking a stable dosage for a quiescent disease in ckd group) 7. antioxidant and/or omega-3 fatty acid use within the 2 weeks prior to testing 8. current tobacco or nicotine use or history of use in the last 12 months 9. marijuana use within 2 weeks prior to testing 10. uncontrolled hypertension in ckd group (bp \>140/90 mmhg) 11. atrial fibrillation 12. active infection or antibiotic therapy 13. hospitalization in the last month
treatment of depression in parkinson's disease

Conditions: Depression in Parkinson's Disease

Summary: the goal of this study is to evaluate the efficacy of traditional chinese medicine-"xiaoyao pill" (herb extracts)on depression, compared to placebo and "bupleurum+ginkgo" in patients with parkinson's disease.

depression as the most common non-motor comorbidity of parkinson's disease (pd), have a negative impact on disability and quality of life. traditional chinese medicine has shown effects on several depression. it is not known if tcm also is effective for depression in pd. this study is to investigate "xiaoyao pill", an antidepressant in tcm, on depression in pd. a total of 60 patients with depression in pd will be randomized to each of the three arms.

Eligibility criteria:
inclusion criteria: * parkinson's disease without dementia * depression * males or females * willing and able to give informed consent exclusion criteria: * cognitive dysfunction * other serious diseases

Keywords: depression; parkinson's disease; antidepressant
comparison between interactive internet-based education and counseling for the management of acne with that of internet-based education alone

Conditions: Acne Vulgaris

Summary: this study will develop and evaluate the efficacy of an internet-based education program incorporating virtual coaching. for this study, the virtual coach will consist of online videos aimed at providing acne education and promoting behaviors that support healthy skin. the use of web-based technologies and virtual coaching in acne-related patient education is novel, and may significantly improve clinical outcomes and quality of life in acne patients. we hypothesize that an interactive internet-based education and counseling program will be more effective than internet-based education alone in improving clinical outcomes and quality of life in acne patients.


Eligibility criteria:
inclusion criteria: * diagnosis of mild to moderate acne vulgaris * 13 years of age or older at time of assent, may be men or women. * able read and understand english. * able to hear and see the educational videos. * access to computer with internet access. * capable of giving informed consent. * not currently using any prescription acne treatment. exclusion criteria: * non-english speaking individuals. * self-reported exposure to environmental or chemical comedogenic agents * women with self-reported hyperandrogenism (e.g., pcos) * women self-reporting current use of any form of specific acne-directed hormonal therapy * men or women with self-reported history of cushing syndrome or congenital adrenal hyperplasia
microcurrent device (tivic health)

Conditions: Chronic Rhinosinusitis

Summary: the purpose of this study is to investigate whether daily use of a microcurrent neuromodulation device, which applies a small current of electricity to the forehead and maxillary region, will decrease the pain experienced by patients in the days following functional endoscopic sinus surgery (fess). this study is a prospective randomized controlled study. enrolled subjects will be randomized (1:1) to receive either an active neuromodulation study device or a sham device that appears identical to the active device while emitting no therapeutic microcurrent. subjects will self-treat with the device at home and will be followed for 2 weeks after fess.


Eligibility criteria:
inclusion criteria: * scheduled for fess functional nasal or endoscopic sinus surgery * possessing an american society of anesthesiologists physical status classification of i or ii * age ≥ 18 * possess the capacity to give informed consent * able to read, write and understand english or spanish * able to attend follow up visits at postop days 7 and 14 visit 1 (within 0 - day 14) and post-op visit 2 (within 10 - 21 days) * postop pain vas ≥ 5 in pacu phase ii exclusion criteria: * age \< 18 * does not understand english or spanish * does not meet inclusion criteria * history of chronic pain * experiencing chronic pain requiring opioids at baseline and/or who are under the care of pain management specialists * neurologic disorders (including seizure disorders) * undergoing planned or unplanned additional procedures at the time of fess surgery * in custody of the state * prisoners * known to be pregnant * implanted cranial metallic components or devices including deep brain stimulators or cochlear implants * has an implanted or external worn cardiac device including pacemakers, automated implantable cardioverter defibrillator (aicd), or any other cardiac electric devices (including non-implanted devices, e.g. defibrillator vest)

Keywords: chronic rhinosinusitis postoperative pain microcurrent
outcome of perioperative immune enhancing nutrition in patients undergoing radical cystectomy

Conditions: Cancer, Bladder; Cystostomy; Complications

Summary: the aim of this study is to evaluate the outcome of perioperative immune-nutrition with glutamine, arginine and fish oil in patients undergoing radical cystectomy as regards to enhancement of healing, increasing immunity and improving overall health status.


Eligibility criteria:
inclusion criteria: 1. patients with ct showing bladder mass with radiological staging of t2 or t3. 2. patients pathologically proven to have cancer bladder. 3. patients undergoing radical cystectomy with ileal conduit. 4. the american society of anesthesiologists physical status classification system (asa ps) of 1, 2 or 3. exclusion criteria: 1. coagulopathy. 2. distant metastasis. 3. body mass index less than 18.5. 4. relevant food allergies. 5. severe renal and hepatic insufficiency.

Keywords: radical cystectomy complications immune-nutrition immune enhancing nutrition bladder cancer muscle invasive bladder cancer
impact of fruit and vegetables in pku

Conditions: Phenylketonurias

Summary: in the uk, some fruits and vegetables are permitted without measurement in the diets of people with phenylketonuria (pku). it is proven that fruits and vegetables containing phenylalanine (phe) up to 75mg/100g (e.g. carrots, sweet potato, tomatoes) do not affect blood phe control but it is unknown to what extent fruits and vegetables containing phe from 76-100mg/100g (e.g. cauliflower, broccoli, beansprouts and asparagus) increase blood phe levels. in addition, there is very little information about how differently animal and vegetable protein affect blood phe levels. it is believed that plant protein may have less bioavailability and therefore have less impact on blood phe control. the investigators aim is to perform a randomized controlled study over 21 weeks in children (5-12y) with pku. children will be studied during five different time periods, examining the effect on blood phe control when increasing phe intake from vegetables/fruits containing phe from 76-100 mg/100g vs. animal sources. at the end of the study, fruits and vegetables containing 76- 100mg phe/100g will continue to be given as "exchange-free" for 6 months. this is a practical, cost effective study and should bring benefit to all people with pku following a very restrictive diet both within the uk and throughout the world.


Eligibility criteria:
inclusion criteria: * pku patients diagnosed by nbs and bh4 deficiencies; * early and continuously treated; * adherent to their prescribed pku diet consisting of a protein-restricted diet and phe-free amino acid based protein substitute; * in good general health as evidenced by medical history; * able to provide written informed consent/assent (parent/child); * able to comply with the study protocol and take study product according to the opinion of the pi; * patients with good metabolic control (age 5-12y, 120-360μmol/l) with 3 out of 4 levels within range prior to consent (if 2 of 4 above target range but one close to the upper limit, pi to decide if patient can enter the study). exclusion criteria: * concomitant diseases / disorders such as renal or gut disease / disorders and diabetes; * dislikes fruits and vegetables containing 76-100 mg of phe/100g e.g.brocolli or cauliflower; * treated with bh4 (sapropterin); * presence of intercurrent infection; * patients with poor metabolic control (age 5-12y, \>360μmol/l).

Keywords: fruit and vegetables phenylalanine animal protein vegetable protein